NHS Constitution is little known, lacks teeth, experts tell govt

The NHS Constitution is little known, and where it is known, it is often dismissed as “a set of fine words lacking teeth,” Ministers have been told.

The Constitution was launched with “some energy” in 2009 but that energy has been allowed to dissipate, and what is needed now is a proper national awareness campaign, funded by the Department of Health and NHS England, with easy-to-read versions of the Constitution to make it more accessible for patients, according to the Expert Advisory Group to the NHS Constitution.

In new recommendations on how the NHS Constitution should be strengthened, the Expert Group says that the relevance, visibility and impact of the Constitution in practice and in the day-to-day delivery of NHS services remain limited, and that “recent experience has provided a stark demonstration of how far parts of the NHS have fallen short of the principles, values and commitments set out in the Constitution.”

There has never been a national campaign to raise awareness of the Constitution aimed at patients and the public, and such efforts directed at staff have often been “patchy and half-hearted,” the panel points out. A national awareness campaign is now needed, run in partnership by the Department and NHS England with Health Education England, clinical commissioning groups (CCGs) and other bodies, backed by sufficient resources including communications, social marketing and social media expertise. The campaign will benefit from the involvement of local Healthwatch, as well as the voluntary and community sector, and “needs to tap into the positive energy for change that exists throughout the NHS,” the Group advises.

And the central feature of the campaign needs to be a range of easy-read and much shorter summary versions of the Constitution, produced by the Department in partnership with others, including voluntary-sector organisations.

The Expert Group also urges the government to look again at the question of legal force. While it does contain legally enforceable rights, the Constitution itself is not legally enforceable, the panel points out, and warns: “we question whether it can ever really have teeth if NHS bodies need only ‘have regard’ to it.”

“When amendments to the Constitution are next consulted on in 2015, consideration should be given to whether the legal duties relating to the Constitution are sufficient, as well as how non-statutory mechanisms can best be exploited to enforce the Constitution, for example NHS England’s CCG assurance framework,” the Group proposes.